18例SAPHO综合征患者临床特征及SPECT/CT全身骨显像特点分析  

Analysis for the whole-body bone scintigraphy features and clinical characteristics of 18 cases of SAPHO syndrome

作　　者：何艳琼 陈钰琦 胡涛[1] HE Yan-qiong;CHEN Yu-qi;HU Tao(The First College of Clinical Medicine Science,Nuclear Medicine of Yichang Department Central People’s Hospital,Yichang Nuclear Medicine Molecular Imaging Laboratory,Yichang Hubei 443003,China)

机构地区：[1]三峡大学第一临床医学院、宜昌市中心人民医院核医学科、宜昌市核医学分子影像实验室,湖北宜昌443003

出　　处：《中国临床医学影像杂志》2023年第7期508-511,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:研究滑膜炎-痤疮-脓疱病-骨肥厚-骨炎(Synovitis,acne,pustulosis,hyperostosis,osteitis,SAPHO)综合征患者临床特征及全身骨显像特点,提高临床医师对SAPHO综合征的诊断水平及认识全身骨显像在SAPHO综合征诊断中的应用价值。方法:回顾性分析18例SAPHO综合征患者的临床资料及全身骨显像资料,总结SAPHO综合征患者的临床特征及全身骨显像特点。结果:本研究共纳入18例SAPHO综合征患者,男7例,女11例,平均发病年龄(51.2±12.2)(31~71)岁。本研究病例以皮肤病变、骨及关节受损为主。以皮肤病变为首发症状就诊的4例,以疼痛为首发症状就诊的12例。所有患者均有不同程度的骨及关节疼痛,以前胸部及脊柱疼痛为主。全身骨显像提示所有患者前胸壁可见显像剂不同程度浓聚,其中呈典型“牛头”征表现的8例,其余均为不完全“牛头”征或单侧“牛头”征。SPECT/CT融合显像示前胸壁以骨皮质肥厚、骨质硬化为主,脊柱以椎体角病变和椎体旁骨化为主,关节以边缘骨质增生硬化为主。结论:SAPHO综合征以女性好发,首发症状表现及出现时间不一,以皮肤病变、骨关节疼痛为常见首发症状。全身骨成像是目前诊断及评估SAPHO综合征极为重要的手段,其“牛头征”是诊断SAPHO综合征的典型特征。Objective:To investigate the clinical manifestations and the whole-body bone features of synovitis,acne,pustulosis,hyperostosis,osteitis(SAPHO)syndrome,and to improve the understanding of this disease and to understand the application value of whole-body bone in SAPHO syndrome.Methods:A retrospective analysis was performed on 18 patients who had complete clinical data and whole body bone imaging.Imaging features and whole body bone imaging characteristics were summarized.Results:There were 18 SAPHO syndrome patients,including 7 males and 11 females,with an average age of onset of(51.2±12.2)(31~71)years old.SAPHO syndrome is characterized by skin lesions and joint lesions.Four cases of the patients visited a doctor with skin disease as the first manifestation.The number of patients seeing a doctor with joint pain as the first presentation was 12 cases.All patients have bone and joint pain,mainly in the anterior chest and spine.The scintigraphy sites in anterior chest wall were also recorded:8 patients with typical bullhead sign,the rest with incomplete bullhead sign.SPECT/CT fusion mainly shows the bone cortex hypertrophy and bone sclerosis,vertebral angle lesions and paravertebral ossification,and marginal bone hyperplasia and sclerosis.Conclusion:SAPHO syndrome generally occurs in women.The timing of the first presentation of SAPHO syndrome varies;skin lesions and joint lesions are often the first manifestations.Whole-body bone imaging is an extremely significant approach for diagnosing and assessing SAPHO syndrome,with the bullhead sign being a typical signs.

关 键 词：获得性骨肥大综合征 单光子发射计算机体层摄影术 

分 类 号：R681[医药卫生—骨科学] R817.4[医药卫生—外科学] R814.42[医药卫生—临床医学]